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Many forces are at play today in healthcare settings that healthcare professionals and administrators should be cognizant of and consider when designing plans for the future direction of healthcare delivery and reform. Some of these contributing factors include political, regulatory, staffing, insurance and reimbursement, socio-economic, and long-term care influences. However, there are still additional factors to be considered. What special interest groups are pushing for legislation and policy specific to their needs? How will the face of healthcare change as the Baby Boomer generation retires and other generations assume the responsibilities for our fast-paced, demanding healthcare environments?